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Cutaneous Fusariosis by a Species of the Fusarium Dimerum in Acute Myeloblastic Leukemia Patient: A Case Report

Received: 25 February 2022    Accepted: 21 March 2022    Published: 29 March 2022
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Abstract

Fusarium is the second most common cause of fungi infections in the immunocompromised patients with the mortality rate over 80%. The Fusarium Dimerum is the less common species. In immunocompromised patients, spatially with prolonged neutropenia, the presenting features of Fusarium infections include persistent refractory fever, localised symptoms such as invasive infections, sinusitis, pneumonia, deep cutaneous infections, and disseminated infections. The dermatological manifestations include onychomycosis, a localised cellulitis at the site of injection, diffuse skin nodules or vesicles in disseminated disease. The diagnosis of skin fusariosis mainly based on cultures from the skin growing Fusarium species and skin biopsy. Amphotericin B represent the potential treatment for Fusarium infection, however, voriconazole is increasingly being used to treat infections unresponsive to the more conventional antifungals. Despite medical intervention, treatment of emerging fungal infections is a major challenge, with no standardized therapy and high mortality rates. We describe the case of Cutaneous fusariosis in a patient with acute myeloid leukemia (AML) undergoing induction chemotherapy. The patient had profound neutropenia and developed multiple ulcerous lesions. The diagnosis of cutaneous infection with Fusarium Dimerium was made on the basis of histopathological findings and skin biopsy culture. The patient was treated with liposomal amphotericin B but, neutropenia perduring, her clinical condition deteriorated with fatal outcome.

Published in American Journal of Laboratory Medicine (Volume 7, Issue 2)
DOI 10.11648/j.ajlm.20220702.12
Page(s) 28-31
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Cutaneous Fusariosis, Fusarium Dimerum, Acute Myeloid Leukemia

References
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[2] Khalid SN, Rizwan N, Khan ZA, Najam A, Khan AM, Almas T, et al. Fungal burn wound infection caused by Fusarium dimerum: A case series on a rare etiology. Ann Med Surg 2012. Oct 2021; 70: 102848.
[3] Dignani MC, Anaissie E. Human fusariosis. Clin Microbiol Infect. 2004; 10 (s1): 67-75.
[4] De Pinho DB, Fernandes LL, Carvalho Barreiros MDG, Quintella LP, Sodré CT, Ramos-E-Silva M. Disseminated Fusariosis in a Bone Marrow Transplant Patient. J Clin Aesthetic Dermatol. déc 2012; 5 (12): 40-2.
[5] Pagano L, Mayor S. Invasive fungal infections in high-risk patients: report from TIMM-8 2017. Future Sci OA. 14 juin 2018; 4 (6): FSO307.
[6] Muhammed M, Coleman JJ, Carneiro HA, Mylonakis E. The challenge of managing fusariosis. Virulence. avr 2011; 2 (2): 91-6.
[7] Delia M, Monno R, Giannelli G, Ianora AAS, Dalfino L, Pastore D, et al. Fusariosis in a Patient with Acute Myeloid Leukemia: A Case Report and Review of the Literature. Mycopathologia. juin 2016; 181 (5-6): 457-63.
[8] Puebla LEJ. Fungal Infections in Immunosuppressed Patients [Internet]. Immunodeficiency. IntechOpen; 2012 [cité 3 mars 2022]. Disponible sur: https://www.intechopen.com/chapters/39805
[9] Tram QA, Minh NTN, Anh DN, Lam NN, Dung TN, Thi Minh Chau N, et al. A Rare Case of Fungal Burn Wound Infection Caused by Fusarium solani in Vietnam. J Investig Med High Impact Case Rep. 1 janv 2020; 8: 2324709620912122.
[10] Cooke NS, Feighery C, Armstrong DKB, Walsh M, Dempsey S. Cutaneous Fusarium solani infection in childhood acute lymphoblastic leukaemia. Clin Exp Dermatol. 2009; 34 (5): e117-9.
[11] Simon L, Gastaud L, Martiano D, Bailleux C, Hasseine L, Gari-Toussaint M. First endogenous fungal endophthalmitis due to Fusarium dimerum: A severe eye infection contracted during induction chemotherapy for acute leukemia. J Mycol Medicale. juin 2018; 28 (2): 403-6.
[12] Al-Hatmi AMS, Curfs-Breuker I, de Hoog GS, Meis JF, Verweij PE. Antifungal Susceptibility Testing of Fusarium: A Practical Approach. J Fungi. 26 avr 2017; 3 (2): 19.
[13] Van Diepeningen AD, Brankovics B, Iltes J, van der Lee TAJ, Waalwijk C. Diagnosis of Fusarium Infections: Approaches to Identification by the Clinical Mycology Laboratory. Curr Fungal Infect Rep. 1 sept 2015; 9 (3): 135-43.
[14] Tortorano AM, Richardson M, Roilides E, van Diepeningen A, Caira M, Munoz P, et al. ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. avr 2014; 20 Suppl 3: 27-46.
[15] Collado C, Medina L, Zorraquino A, Baeza T, Ferrer C, Plazas J, et al. Cutaneous fusariosis by a species of the Fusarium dimerum species complex in a patient with acute mieloblastic leukemia. Rev Iberoam Micol. 1 avr 2013; 30 (2): 119-21.
[16] Letscher-Bru V, Campos F, Waller J, Randriamahazaka R, Candolfi E, Herbrecht R. Successful outcome of treatment of a disseminated infection due to Fusarium dimerum in a leukemia patient. J Clin Microbiol. mars 2002; 40 (3): 1100-2.
[17] Stanzani M, Tumietto F, Vianelli N, Baccarani M. Update on the treatment of disseminated fusariosis: Focus on voriconazole. Ther Clin Risk Manag. déc 2007; 3 (6): 1165-73.
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    Ikram Sebbane, Fatimaezzahra Lahlimi, Illias Tazi, Asmaa Lahrougui, Said Amal. (2022). Cutaneous Fusariosis by a Species of the Fusarium Dimerum in Acute Myeloblastic Leukemia Patient: A Case Report. American Journal of Laboratory Medicine, 7(2), 28-31. https://doi.org/10.11648/j.ajlm.20220702.12

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    ACS Style

    Ikram Sebbane; Fatimaezzahra Lahlimi; Illias Tazi; Asmaa Lahrougui; Said Amal. Cutaneous Fusariosis by a Species of the Fusarium Dimerum in Acute Myeloblastic Leukemia Patient: A Case Report. Am. J. Lab. Med. 2022, 7(2), 28-31. doi: 10.11648/j.ajlm.20220702.12

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    AMA Style

    Ikram Sebbane, Fatimaezzahra Lahlimi, Illias Tazi, Asmaa Lahrougui, Said Amal. Cutaneous Fusariosis by a Species of the Fusarium Dimerum in Acute Myeloblastic Leukemia Patient: A Case Report. Am J Lab Med. 2022;7(2):28-31. doi: 10.11648/j.ajlm.20220702.12

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  • @article{10.11648/j.ajlm.20220702.12,
      author = {Ikram Sebbane and Fatimaezzahra Lahlimi and Illias Tazi and Asmaa Lahrougui and Said Amal},
      title = {Cutaneous Fusariosis by a Species of the Fusarium Dimerum in Acute Myeloblastic Leukemia Patient: A Case Report},
      journal = {American Journal of Laboratory Medicine},
      volume = {7},
      number = {2},
      pages = {28-31},
      doi = {10.11648/j.ajlm.20220702.12},
      url = {https://doi.org/10.11648/j.ajlm.20220702.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20220702.12},
      abstract = {Fusarium is the second most common cause of fungi infections in the immunocompromised patients with the mortality rate over 80%. The Fusarium Dimerum is the less common species. In immunocompromised patients, spatially with prolonged neutropenia, the presenting features of Fusarium infections include persistent refractory fever, localised symptoms such as invasive infections, sinusitis, pneumonia, deep cutaneous infections, and disseminated infections. The dermatological manifestations include onychomycosis, a localised cellulitis at the site of injection, diffuse skin nodules or vesicles in disseminated disease. The diagnosis of skin fusariosis mainly based on cultures from the skin growing Fusarium species and skin biopsy. Amphotericin B represent the potential treatment for Fusarium infection, however, voriconazole is increasingly being used to treat infections unresponsive to the more conventional antifungals. Despite medical intervention, treatment of emerging fungal infections is a major challenge, with no standardized therapy and high mortality rates. We describe the case of Cutaneous fusariosis in a patient with acute myeloid leukemia (AML) undergoing induction chemotherapy. The patient had profound neutropenia and developed multiple ulcerous lesions. The diagnosis of cutaneous infection with Fusarium Dimerium was made on the basis of histopathological findings and skin biopsy culture. The patient was treated with liposomal amphotericin B but, neutropenia perduring, her clinical condition deteriorated with fatal outcome.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Cutaneous Fusariosis by a Species of the Fusarium Dimerum in Acute Myeloblastic Leukemia Patient: A Case Report
    AU  - Ikram Sebbane
    AU  - Fatimaezzahra Lahlimi
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    AU  - Asmaa Lahrougui
    AU  - Said Amal
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    DO  - 10.11648/j.ajlm.20220702.12
    T2  - American Journal of Laboratory Medicine
    JF  - American Journal of Laboratory Medicine
    JO  - American Journal of Laboratory Medicine
    SP  - 28
    EP  - 31
    PB  - Science Publishing Group
    SN  - 2575-386X
    UR  - https://doi.org/10.11648/j.ajlm.20220702.12
    AB  - Fusarium is the second most common cause of fungi infections in the immunocompromised patients with the mortality rate over 80%. The Fusarium Dimerum is the less common species. In immunocompromised patients, spatially with prolonged neutropenia, the presenting features of Fusarium infections include persistent refractory fever, localised symptoms such as invasive infections, sinusitis, pneumonia, deep cutaneous infections, and disseminated infections. The dermatological manifestations include onychomycosis, a localised cellulitis at the site of injection, diffuse skin nodules or vesicles in disseminated disease. The diagnosis of skin fusariosis mainly based on cultures from the skin growing Fusarium species and skin biopsy. Amphotericin B represent the potential treatment for Fusarium infection, however, voriconazole is increasingly being used to treat infections unresponsive to the more conventional antifungals. Despite medical intervention, treatment of emerging fungal infections is a major challenge, with no standardized therapy and high mortality rates. We describe the case of Cutaneous fusariosis in a patient with acute myeloid leukemia (AML) undergoing induction chemotherapy. The patient had profound neutropenia and developed multiple ulcerous lesions. The diagnosis of cutaneous infection with Fusarium Dimerium was made on the basis of histopathological findings and skin biopsy culture. The patient was treated with liposomal amphotericin B but, neutropenia perduring, her clinical condition deteriorated with fatal outcome.
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Department of Hematology and Bone Marrow Transplantation Mohammed VI University Hospital, Cadi Ayyad University, Marrakesh, Morocco

  • Department of Hematology and Bone Marrow Transplantation Mohammed VI University Hospital, Cadi Ayyad University, Marrakesh, Morocco

  • Department of Hematology and Bone Marrow Transplantation Mohammed VI University Hospital, Cadi Ayyad University, Marrakesh, Morocco

  • Department of Dermatology Mohammed VI University Hospital, Cadi Ayyad University, Marrakesh, Morocco

  • Department of Dermatology Mohammed VI University Hospital, Cadi Ayyad University, Marrakesh, Morocco

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